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Inspection on 25/10/05 for Benedict House Nursing Home

Also see our care home review for Benedict House Nursing Home for more information

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service Users stated that staff were kind and caring, and responded promptly to call bells. One said, "they all look after me very well." Service Users are able to stay in their rooms or join in with activities as preferred, and there was a good range of activities offered considering most Service Users have high dependency needs, and cannot take part in many activities. The home has a number of small quiet areas on each floor, with room for 2-4 armchairs. These provide the opportunity for sitting quietly in different areas, without Service Users having to stay in their rooms if they don`t want to mix freely. These are also areas where Service Users can sit and chat with relatives or visitors. The new Manager provides a clear leadership presence in the home, and is supported by a committed team of staff, many of whom have worked at the home for several years.

What has improved since the last inspection?

Previous requirements and recommendations given at the last inspection had been met, or were in the process of being met. The Manager has instigated a new care planning system, which is much easier to follow than the previous system, with a better layout of care records, and more comprehensive information. Only one of these care plans had been completed up to this time. This system includes more details in respect of social, cultural and emotional needs, and has the potential for showing ongoing care regarding nutrition, wound care etc. New bathing and shower facilities had been installed, and this ensured a wider range of choice for Service Users. A newly fitted bathroom on the top floor includes a bath with a disinfection system, and integral hoisting facilities. A number of rooms and corridors had been redecorated since the previous inspection, and the work had been carried out to a high standard.

What the care home could do better:

There is an ongoing requirement to complete all care plans in the new format, ensuring that the care is properly reflected in detailed documentation. This will entail additional staff training, to ensure that nurses and care staff are able to follow the new system, and complete the records effectively and with clear and legible writing. Medication administration was well managed except for the arrangements for the disposal of unused medication. The Manager was aware that there is new legislation for this, and had commenced proceedings for new arrangements. These need to be finalised, to ensure that stocks of spare or old medication are not being stored on the premises. Staff files were neatly maintained, but did not include an up to date photograph of each staff member. There is a requirement to ensure this is carried out. The Inspector expressed concern about the amount of space available for storing and management of medication. There is a recommendation to consider this in long term future planning for alterations to the property.

CARE HOMES FOR OLDER PEOPLE Benedict House Nursing Home 63 Copers Cope Road Beckenham Kent BR3 1NJ Lead Inspector Mrs Susan Hall Unannounced Inspection 25th October 2005 09.50 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Benedict House Nursing Home Address 63 Copers Cope Road Beckenham Kent BR3 1NJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8663 3954 020 8658 1337 Sunglade Care Ltd Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Notice issued 17 January 2000 Date of last inspection 16th June 2005 Brief Description of the Service: Benedict House is a large detached building situated in a residential area of Beckenham. It is near to local town facilities, and is easily reached by public transport. The home is an older building, and is suitable for the nursing care of older people. The home’s owner lives in the vicinity, but he does not oversee day-to-day control of the home. Management is carried out by Sunglade Care Ltd. Accommodation is on four floors (lower ground, ground, first and second floors), and there are bedrooms situated on each floor. Access to all floors is facilitated by a passenger lift. There is a mixture of single and shared rooms, and some have en-suite toilet facilities. There are communal areas on the ground floor and lower ground floor, as well as smaller quiet areas on the first and second floors. The activities room on the lower ground floor leads out through patio doors to a small garden, which is enhanced by a patio area and tubs of flowers. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out from 09.50 – 15.45 hours, and the Inspector found the home to have a welcoming and friendly atmosphere. The building was generally well maintained, and much of it had been redecorated during the previous few months. The Inspector was pleased to be able to meet the management consultants from Sunglade during the day (Peter and Andrea Barden), and discussed ongoing improvements with them. A new Home Manager (Glenda Edwards) was appointed at the end of May 2005, and assisted the Inspector throughout the day. She had applied to CSCI for formal registration, but this process had not yet been completed. The Inspector viewed most of the building, including several bedrooms on each floor, communal areas, toilet and bathroom facilities, kitchens, laundry and clinical rooms. She was able to talk freely with Service Users and staff, and had conversations with 7 Service Users, 1 relative, and 7 staff. These included the Administrator, a cook, handyman, nurses and carers. She also met other staff briefly, such as domestic staff, kitchen assistant, and other care staff, who were all busy carrying out their duties. The inspection included medication administration, and reading documentation such as care plans, staff files, maintenance records, complaints log and accident records. What the service does well: What has improved since the last inspection? Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 6 Previous requirements and recommendations given at the last inspection had been met, or were in the process of being met. The Manager has instigated a new care planning system, which is much easier to follow than the previous system, with a better layout of care records, and more comprehensive information. Only one of these care plans had been completed up to this time. This system includes more details in respect of social, cultural and emotional needs, and has the potential for showing ongoing care regarding nutrition, wound care etc. New bathing and shower facilities had been installed, and this ensured a wider range of choice for Service Users. A newly fitted bathroom on the top floor includes a bath with a disinfection system, and integral hoisting facilities. A number of rooms and corridors had been redecorated since the previous inspection, and the work had been carried out to a high standard. What they could do better: There is an ongoing requirement to complete all care plans in the new format, ensuring that the care is properly reflected in detailed documentation. This will entail additional staff training, to ensure that nurses and care staff are able to follow the new system, and complete the records effectively and with clear and legible writing. Medication administration was well managed except for the arrangements for the disposal of unused medication. The Manager was aware that there is new legislation for this, and had commenced proceedings for new arrangements. These need to be finalised, to ensure that stocks of spare or old medication are not being stored on the premises. Staff files were neatly maintained, but did not include an up to date photograph of each staff member. There is a requirement to ensure this is carried out. The Inspector expressed concern about the amount of space available for storing and management of medication. There is a recommendation to consider this in long term future planning for alterations to the property. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 There are good systems in place for assessing Service Users prior to arranging admission to the home. EVIDENCE: The Statement of Purpose and Service Users’ Guide were not inspected at this visit. The Manager stated that these were having amendments made to reflect her appointment as Manager, and to include alterations made to the internal structure and facilities in the building. Pre-admission assessments are carried out by the Manager, using a prepared format. Most Service Users are admitted from hospital or residential homes, and Service Users are not usually well enough to be able to cope with a preadmission visit. The Manager visits them, and discusses their nursing needs with other health professionals, and relatives (where applicable). The assessment includes ensuring that the room available will be suitable, and that the staff will be able to meet all the needs in relation to personal care, social needs, mobility and communication needs. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 10 The Inspector viewed a completed pre-admission form, and this had been well completed, and contained all relevant details. Admission would be refused for Service Users who are in categories of care outside the ability of the staff and their training. Service Users are admitted for a trial period of 4 weeks, and a review is held at the end of this time to discuss the suitability of the placement, and to ensure that the Service User’s needs are being satisfactorily met. One Service User was unhappy in the home and was looking to move elsewhere. She indicated that this was not related to her care, rather that she would prefer a different type of home. The Manager was facilitating the process of looking for an alternative placement for this Service User. The Inspector noted that 2 Service Users had developed dementia during their time in the home, and this had been diagnosed by relevant health professionals. The Service Users had been re-assessed by Social Services staff, who were confident that their care needs were currently being met in the home. However, the Inspector stressed the importance of applying to CSCI for a variation in registration to cover the 2 Service Users in this category, so that this situation will be kept under review. This will be discussed with the CSCI Regulation Manager for this area. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 Current care plans contain satisfactory information, but need the proposed upgrading to ensure that data is comprehensive and easily accessible. Health care needs are well met, with relevant input from other health professionals. Medication systems are satisfactory with the exception of disposal of unused medication. EVIDENCE: The Manager has produced 1 care plan in a new format, and the Inspector compared this with the existing care plan for the same Service User. The format included an overview of personal details and medical history, followed by assessment profiles for skin care and pressure areas, moving and handling needs, a falls risk assessment, nutritional assessment, and individualised risk assessments. These included aspects of care such as risks of wandering, infection, and skin deterioration. Care plans are instigated according to the needs of each person, but include some compulsory care plans for all Service Users for personal hygiene needs, spiritual and religious needs, social and leisure needs, sleep pattern, nutritional needs and mobility. Additional care Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 12 plans are commenced as needed, and may include subjects such as incontinence, bowel care, communication, pain management or confusion. The care plans contain pre-printed sections with space for additional specific directions for each Service User. These are backed up by daily charts to specify when bath/shower/hair/ nail care etc. are given. Additional pages are for daily reports and to document visits from health professionals. The Inspector read another 3 Service Users’ files in the old format. These were adequate in most respects, but did not show how assessments were followed through with the relevant care plans. The new system is more specific in following through how nutritional needs are met, and how social, communication and cultural needs are met. There is an ongoing requirement to complete all care plans in the new format, with a new date given for completion. The Manager said that printing errors with the new format had delayed the process. Her intention is to complete all care plans and have them ready to use, while carrying out staff training in how to complete them. All new plans will then be commenced at the same time. The current system has daily reports completed by nurses, but the new system will enable more written input from care staff as well. Good records are maintained for visits from professionals such as doctors, chiropodists, Care Liaison Team (specialist nurses), and dietician. There has been an ongoing problem with allocating GPs on a long term basis, and the Manager has been very proactive in addressing this difficulty. Service Users were well groomed and dressed, and said that they felt well cared for. Some were resting in bed, and others were sitting in their rooms or in communal areas. The home will try to enable Service Users to stay in their own rooms if their care is becoming terminal, and hospital admission would only be arranged if there were aspects of care which the home could not meet. Medication systems and administration were checked for all floors, and this was being well managed considering the difficulties posed by lack of space in the clinical room on the first floor. This is used to store medicine trolleys for the first and second floors, and has tiny hand washing facilities, and cupboards which are not easily accessible. There are higher possibilities of errors occurring where trolleys have to be taken in and out to reach other items. There is a separate clinical room on the lower ground floor, for that floor and the ground floor. There is a recommendation to consider the amount of clinical room space in long term future planning for alterations to the property. Medication Administration Records (MAR charts) had been well completed. The Manager had not yet finalised arrangements for removal of unwanted medicines from the property. Previous procedures have to be altered to comply with new legislation. There is a requirement to ensure this is put in place. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Adequate resources are provided to enable Service Users to carry out preferred activities, and to have links with the local community. A good choice of food is offered to Service Users, and provides them with a nutritious and varied diet. EVIDENCE: The home has a large lounge on the ground floor which is an ideal area for larger gatherings. This is sometimes used for watching videos on TV together, parties, or visiting entertainment from singers etc. A church service is held in the home every month. An activities room on the lower ground floor is used for other activities such as art or bingo; and on the day of the inspection, 4 Service Users had decided to sit at the table there for lunch together. The activities room leads out on to the patio and garden. The Manager said that Service Users and relatives had had a cream tea outside in the summer, and had celebrated V.E. day together outside. There is also opportunity for helping the handyman with gardening (especially with the flower tubs), and sometimes Service Users enjoy this. Additional activities were being arranged for Christmas time. Some Service Users preferred to stay in their rooms, and had crossword books, newspapers, TV etc, as wanted. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 14 Visitors are welcome at any time, and can take Service Users out if they can manage their care effectively. Some Service Users were having arrangements made to go out to visit relatives during the Christmas period, and were looking forward to this. The Inspector viewed the kitchens, and these were clean and well organised. A Kitchen Assistant was busy clearing up after lunch. There is a controlled cleaning programme in place, and fridge and freezer temperatures are recorded daily. Items in the fridges were appropriately labelled and dated. Menus are prepared on a 4 weekly rota basis, and the cook discusses possible changes to the menu with the Manager and Service Users. A choice of main meals, desserts and evening meal are always prepared, and the cook visits Service Users during the week to see if they are enjoying their food. Soft diets and diabetic diets are available, and pureed meals are prepared in individual foods, so that they appear more appetising. Home made cakes, sandwiches, and biscuits are available with evening drinks, or during the night if wanted. Fresh fruit and vegetables are delivered every week, and the cook buys in ready prepared fruit salad made with all soft fruits (e.g. melon, kiwi, strawberries). Service Users can have a choice of breakfast items, and a cooked breakfast is offered once per week on a Friday, offering some variety in the week. Cooked foods are placed into 2 hot trolleys at meal times, and the meals are then served out by the nurses and care staff. This enables them to carry out suitable portion control, and to see that Service Users are getting good nutrition. There are usually several Service Users who need assisting with their food, and time is taken to ensure that Service Users are not rushed, and are helped as needed. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 There is a good complaints procedure in place. Staff recruitment and training are carried out with the correct safeguards to prevent Service Users from the risk of abuse. EVIDENCE: The complaints procedure encourages Service Users and visitors to contact the person in charge on the day, or the Manager, as soon as possible, in order to discuss any concerns. The Inspector viewed the complaints log, and there is a system in place for recording details of complaints and the action taken. There had been no complaints to the Home since January 2005, and the concerns raised at that complaint had been addressed sympathetically, and with attention to detail. Service Users felt that they are listened to, and that staff will act on their concerns. Staff recruitment procedures include checking the POVA (Protection of Vulnerable Adults) list, and CRB (Criminal Record Bureau) checks, prior to confirmation of employment. Prevention of adult abuse is included in the induction programme, and staff attend a training day for Adult Protection. This was evidenced in certificates seen in staff files, and on a computer training matrix. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 - 26 The Home was generally well presented, clean throughout, and light and airy. There is an ongoing plan of maintenance and alterations to the premises, to improve and enhance the facilities further. EVIDENCE: General maintenance of the home is overseen by a handyman, who works throughout the week, and carries out routine repairs, redecoration, and checking of fire alarm and water heating systems. Many areas of the home had been repainted and recarpeted during the past year, including communal areas, corridors, and some bedrooms. Furniture and fittings are of a good quality. The home has a dining room and a large lounge on the ground floor, an activities room on the lower ground floor, and other small seating areas throughout the home. The Management Consultants were in the process of considering some possible alterations to the premises, to increase the numbers of en-suite single rooms, as there are currently 10 shared rooms. Alterations to one shared room Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 17 adjacent to the Manager’s office were due to commence during the week of the inspection. The Inspector viewed bedrooms on each floor, and these were homely and attractive, with evidence of Service Users’ personal belongings, pictures and ornaments. Service Users can bring in items of their own furniture as agreed with the Manager. A vacant bedroom had been newly decorated, and was attractively presented. The home provides a variety of different bathing and shower facilities, and these included a new bath fixture on the second floor, where the bath has an in-built disinfection system as well as integral hoisting facilities. There are plans to alter another bathroom, which may possibly include a spa bath in future. Some bedrooms have en-suite toilet facilities, and disabled toilets are sited near to communal rooms. The home is provided with suitable nursing beds, and bed rails for Service Users at risk of falling out of bed. These are used on a risk-assessed basis, and with proper “bumpers” to protect Service Users. Other equipment available includes grab rails, raised toilet seats, several mobile hoists, and pressurerelieving mattresses and cushions. Additional pressure-relieving equipment is obtained on loan if needed at short notice. The hoists had been serviced within the last year, and the home has a variety of slings to use with these. The laundry is equipped with 2 washing machines and a tumble dryer, and was seen to be tidy and well organised. It is staffed by a Laundry Assistant every day, and these staff check to see that clothing items are properly labelled. A red alginate bag system is used for dealing with items of soiled clothing. There is a separate area for clean items of clothing, and these are sorted into named baskets, and returned to Service Users each day. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 Numbers of staff on duty each day are sufficient to meet the needs of the home. Satisfactory recruitment procedures are in place, and there is a commitment to ensure suitable staff training. EVIDENCE: There are 2 nurses on duty for each shift throughout the day, and 1 nurse at night. As bedrooms are spread over 4 floors, it is important that these levels of trained staff are maintained. There are usually 8 care staff throughout the day, so that 2 care staff work on each floor during the busy times of getting Service Users washed and dressed, or helping them to bed. This staffing also provides enough staff to assist Service Users with meals and drinks throughout the day. There are 4 care staff on duty at nights. Numbers of care staff are sometimes reduced in accordance with the numbers of vacancies, but still ensuring the same ratio, and sufficient to meet the dependency levels of Service Users. The staff team includes a cook and a kitchen assistant for day time and evenings; 3 cleaning staff each day; a laundry assistant; an Administrator from Monday to Fridays, and the handyman. The Home did not currently have an activities assistant, but the Manager was in the process of recruiting one. Care staff were assisting with activities where possible in the meantime. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 19 The home had 3 care staff who had completed NVQ 2 training, and a number of others were due to commence this. The Inspector did not check actual numbers of those starting, but the percentage of those with NVQ training is below the proposed figure of 50 by the end of 2005. There is a recommendation to continue to promote this training. The Inspector examined 3 staff files. These showed satisfactory recruitment procedures in respect of completed application forms, interview records, health questionnaires, CRB checks, PIN number checks (for trained staff), 2 written references, and work permits (where applicable.) Not all staff files included a recent photograph, and there is a requirement to ensure these are completed on file, in line with the (amended) requirements of Schedule 2 of the Regulations. Staff files included records of staff training, with verification of qualifications and completed training courses. The Manager stated that the induction procedures followed current guidelines, but the Inspector did not view these as they were in the process of being updated. Foundation training during the first 6 months includes all mandatory training for staff, and evidence of this was seen on the computer training matrix. The Inspector was pleased to see verification of ongoing training for trained staff. Some had completed courses in subjects such as venepuncture and leg ulcer management, and this confirmed that they are assisted in keeping their training up to date. Some staff had carried out a day course in dementia care. This training needs to be considered when a variation is sought for any Service Users with a diagnosis of dementia, so that staff understand how to carry out this specialised care. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36,37,38 The Manager providers a clear sense of direction and leadership in the home, and is supported by a good team of staff. Good processes are in place to enable staff and Service Users to share their views. Health and safety procedures are implemented satisfactorily. EVIDENCE: The Manager has completed NVQ 4 and RMA (Registered Managers’ Award) training in line with the requirements, and has applied to CSCI for formal registration. She carries out some nursing shifts as well as the home’s management, and is assisted by a Deputy Manager who is also a trained nurse. Staff were seen to interact well with Service Users, visitors and with each other. This was a credit to the way in which staff from different cultures and Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 21 backgrounds are able to work well together. Staff meetings are held to enable all staff to share concerns and ideas, and there are additional meetings for trained staff. The Manager is available in the Home on most days, and has an open door policy for relatives and visitors to talk with her. She speaks to Service Users individually throughout the week, and is available to discuss any matters of concern with them. The Manager has commenced individual staff one-to-one supervision, and this follows a set format to enable all staff to discuss practical issues in the home, and ongoing training needs. Records viewed were in good order and up to date, and are appropriately stored to maintain confidentiality. Safe working practices were confirmed by the provision of courses for staff in subjects such as moving and handling, first aid, and basic food and hygiene. Accident records were viewed, and accidents were well documented. However, the book being used to record accidents did not comply with current Health and Safety legislation and the Data Protection Act 1998. There is a recommendation to ensure that the home complies with all other relevant legislation. The Administrator acted promptly during the inspection to find out where to order the correct record book, and make this available. The Inspector suggested to the Manager a method for carrying out monthly accident audits. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (2) Requirement Ongoing requirement to complete all care plans in the new format (with new date for completion.) To make arrangements for the disposal of unused medication. To ensure that each staff file includes a recent photograph of the staff member. Timescale for action 31/01/06 2 3 OP9 OP29 13 (2) 18 (1-5) 30/11/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP28 OP38 Good Practice Recommendations To consider making space for a more suitable clinical room in long-term planning for the home. To continue to promote NVQ training for care staff, in order to increase the percentage of carers with NVQ 2 training. To record accidents in compliance with Health and Safety legislation and the Data Protection Act 1998. Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Benedict House Nursing Home DS0000010127.V256705.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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